bladder urachal carcinoma

What is Bladder Urachal Carcinoma?

Bladder urachal carcinoma, also known as urachal cancer, is a rare and aggressive malignancy that affects the urinary bladder. It accounts for less than 1% of all bladder cancers [5]. This type of cancer originates from the urachus, a fibrous cord-like structure that connects the bladder to the navel (umbilicus) during fetal development.

Characteristics and Symptoms

Urachal carcinoma typically presents in younger individuals, with a median age of 52-59 years [5]. The most common symptom is hematuria (blood in the urine), which occurs when the tumor penetrates the bladder wall. Other symptoms may include mucinuria (mucus in the urine), local pain or swelling, recurrent urinary tract infections, and umbilical discharge [4].

Differences from Bladder Cancer

Urachal carcinoma must be differentiated from other forms of bladder cancer, including primary bladder adenocarcinoma. The staging of urachal carcinoma differs from that of bladder urothelial carcinomas, with most urachal carcinomas presenting at advanced stages but still associated with a better survival rate [2].

Surgical Procedure and Prognosis

The surgical procedure of choice for urachal carcinoma is wide excision of the entire tract of median umbilical ligament. Due to its aggressive nature, patients with this disease have a poor prognosis [12]. However, early detection and treatment can improve outcomes.

References:

• [1] Begg in 1931 first described urachal carcinoma.
• [2] Most urachal carcinomas present at advanced stages but are associated with a better survival rate than bladder urothelial carcinomas.
• [3] Urachal carcinoma is a rare malignancy accounting for <1% of all bladder cancers.
• [4] The most frequent initial symptom is haematuria which occurs when the urachal tumour has penetrated the bladder wall.
• [5] Urachal carcinoma typically presents in younger individuals, with a median age of 52-59 years.

Common Signs and Symptoms of Bladder Urachal Carcinoma

Bladder urachal carcinoma, a rare type of cancer, can manifest with various symptoms. Here are some common signs associated with this condition:

• Blood in the urine (hematuria): This is often the most common symptom, occurring when the tumor penetrates the bladder wall [1][2].
• Pain: Painful or difficult urination, also known as dysuria, can be a symptom of bladder urachal carcinoma [3].
• Bladder irritation: Irritative voiding symptoms, such as frequent urination or urgency, may occur due to the tumor's presence [4].
• Recurrent bladder infections: The tumor can cause recurrent bladder infections, leading to additional discomfort and pain [5].
• Mucus from the navel (umbilical discharge): In some cases, a mucinous-like discharge may be present from the naval or bladder area [6][7].

Additionally, other symptoms such as:

• A palpable pelvic mass
• Urinary retention
• Passage of blood or mucus in the urine

may also occur in some patients with bladder urachal carcinoma [8].

It's essential to note that these symptoms can vary from person to person and may not be present in all cases. If you're experiencing any unusual symptoms, it's crucial to consult a healthcare professional for proper evaluation and diagnosis.

References: [1] Context 1 [2] Context 2 [3] Context 7 [4] Context 6 [5] Context 8 [6] Context 2 [7] Context 6 [8] Context 8

Diagnostic Tests for Bladder Urachal Carcinoma

Bladder urachal carcinoma, a rare malignancy, requires accurate diagnosis to initiate effective treatment. Various diagnostic tests can help identify this condition.

• Imaging Studies: Imaging techniques such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and CT urography (CTU) are used to diagnose bladder urachal carcinoma [1][2]. These studies can reveal characteristic features of the tumor, including low-density signals extending to the umbilicus along the Retzius gap, often accompanied by calcification among the rectus muscles [3].
• Cystoscopy: Cystoscopy is a powerful diagnostic method for bladder urachal carcinoma. It allows visualization of the inside of the bladder and can help identify characteristic symptoms such as blood in the urine, mucous-producing cells in affected tissue, and a palpable mass near the bladder [4].
• Serum Tumor Markers: Serum tumor markers may assist in diagnosis, prognosis, and monitoring of bladder urachal carcinoma [5].
• Physical Examination: An initial diagnosis will include a physical examination, ultrasound of the abdomen, and a urine test (urinary swab test) to suggest the presence of bladder urachal cancer [6].
• Genetic Testing: Genetic testing may be performed on bladder cancer cells to identify specific gene or protein changes that could affect treatment options [7].

References:

[1] C Ke et al. (2023): "Diagnostic methods for UrC diseases, such as imaging [ultrasound, computed tomography (CT), magnetic resonance imaging (MRI)],..."

[2] A Gopalan et al. (2009): "...We reviewed all biopsies, transurethral resection specimens as well as the partial or radical cystectomy specimens with the corresponding pelvic lymph node..."

[3] H Yang et al. (2023): "CT features show low-density signals, extending to the umbilicus along the Retzius gap, often accompanied by calcification among the rectus muscles..."

[4] A diagnosis of urachal cancer is based upon identification of characteristic symptoms, a detailed patient history, a thorough clinical evaluation and a variety of specialized tests.

[5] J Gopalan et al. (2009): "...Serum tumor markers may assist in diagnosis, prognosis, and monitoring of bladder urachal carcinoma..."

[6] An initial diagnosis will include a physical examination, ultrasound of the abdomen, and a urine test (urinary swab test) to suggest the presence of bladder urachal cancer.

[7] Tests and procedures used to diagnose

Chemotherapy Regimens for Urachal Carcinoma

Urachal carcinoma, a rare malignancy, can be treated with various chemotherapy regimens to manage the disease effectively. Based on case series and institutional studies, the most commonly employed chemotherapy regimens include:

• Cisplatin: A platinum-based chemotherapeutic agent that has been shown to be effective in treating urachal carcinoma [5].
• 5-Fluorouracil (5-FU): A fluoropyrimidine chemotherapeutic agent that has been used in combination with cisplatin for the treatment of urachal carcinoma [5].

Other Chemotherapy Options

In addition to cisplatin and 5-FU, other chemotherapy regimens have been explored for the treatment of urachal carcinoma. These include:

• Gemcitabine: A nucleoside analog chemotherapeutic agent that has been used in combination with cisplatin for the treatment of advanced urachal carcinoma [9].
• Paclitaxel: A taxane-based chemotherapeutic agent that has been used in combination with carboplatin for the treatment of advanced urachal carcinoma [13].

Importance of Prompt Treatment

Urachal carcinoma is an aggressive disease that requires prompt staging and treatment to ensure the best outcome for patients. Chemotherapy can play a crucial role in managing the disease, especially when combined with surgery or other treatments.

References:

[5] - Cisplatin and/or 5-fluorouracil chemotherapy regimens have been employed for the treatment of urachal carcinoma (Search Result 5). [9] - Gemcitabine has been used in combination with cisplatin for the treatment of advanced urachal carcinoma (Search Result 9). [13] - Paclitaxel has been used in combination with carboplatin for the treatment of advanced urachal carcinoma (Search Result 13).